Organization
PBH PROFESSIONAL GROUP, P.A.
Active
Organization
PBH PROFESSIONAL GROUP, P.A.
Active
Other names
PATH Brazos Valley Professional Group
Organization subpart
No
Provider details
NPI number
Authorized official
FLORA SADRI-AZARBAYEJANI D.O. (PRESIDENT AND SECRETARY)
(413) 522-9246
Entity
Organization
Contact information
Practice address
3550 NORMAND DR STE 100, COLLEGE STATION, TX 77845-6399
(979) 218-5916
(979) 401-4170
Mailing address
103 POWELL CT STE 100, BRENTWOOD, TN 37027-5050
(615) 308-7871
(615) 261-8901
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
—
—
207Q00000X
Family Medicine Physician
—
—
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
—
—
2084P0800X
Psychiatry Physician
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
07/29/2021
Last updated
07/29/2021
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